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<table width="700px" border="0" cellspacing="0" cellpadding="5" align="left">
<tr>
<td valign="top" style="text-align:center"><p><strong>SAMPLE GRANT AGREEMENT</strong></p></td>
</tr>
<tr>
<td valign="top"><p>The undersigned Recipient hereby acknowledges and accepts the terms and conditions of the Grant Agreement.</p></td>
</tr>
</table>
<table width="300px" border="0" cellspacing="0" cellpadding="5" align="left">    
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<td valign="top" style="color:#ffffff; height: 50px; min-height: 60px;">.</td>
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<tr>
<td style="border-bottom: 1px solid #555;"><!--signature ~email~;SIGNER;~firstname~;~lastname~;~Index~;~companyname~--><div style="color: rgb(255, 255, 255);">SignHere~Index~</div>
<div style="color:#ffffff">DateSigned</div></td>
</tr>
<tr>
<td valign="top"><div style="">~firstname~ ~lastname~</div>
<div style="font-size: 12px; padding-top: 4px;">~title~</div>
<div style="font-size: 12px; padding-top: 4px;">~companyname~</div></td>
</tr>
<tr>
<td style="height: 200px; min-height: 200px;">Custom Text Area:<!--FieldBlock fieldCTA;;0;;10;;250;;120;;TEXTAREA--><div style="color: rgb(255, 255, 255);">fieldCTA~Index~</div>
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<td style="height: 100px; min-height: 100px;">Custom Text Field:<!--FieldBlock fieldCTF;;0;;10;;250;;40;;TEXTFIELD--><div style="color: rgb(255, 255, 255);">fieldCTF~Index~</div>
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#] 
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